HEDIS Coordinator

<strong>Working at Advantasure is more than a job &mdash; you&rsquo;re part of a team that is becoming the country&rsquo;s leading healthcare solutions provider.<br /></strong><br /><strong>A career at Advantasure means you&rsquo;ll be part of one of the most dynamic, diversified and innovative healthcare companies in the nation. You&rsquo;ll be helping our clients make their members healthier &mdash; and our communities a better place to call home.</strong>

Southfield, USA

Advantasure

<p class="p1"><strong>At Advantasure, we partner with healthcare clients to simplify their operations and accelerate their business success. Powered by our broad expertise and a comprehensive suite of product and service solutions, we help health plans effectively navigate the complexity of healthcare.</strong></p> https://advantasure.com/

keywords: job description,coordinate,analysis,compliance,performance,other duties,education & experience,knowledge,problem solving,skills

Non-Manager

Competitive Compensation and Benefits Package

Overview: <br /> <p><strong>THIS POSITION CAN BE REMOTE ACROSS THE US</strong></p> <p>The Quality Senior Analyst is an analytical role responsible for HEDIS Operations project support and coordination of the development and implementation of programs and strategies to improve service to our customers.<br /><br /></p> <p><strong>WORKING CONDITIONS:</strong></p> <p>Work is performed in an office setting with no unusual hazards.&nbsp;</p>
Responsibilities: <br /> <ul> <li>Coordinates client HEDIS audit management requirements (Roadmap, monitoring HEDIS timelines, audit review, medical record review validation, etc.).</li> <li>Coordinates medical record review projects including provider data cleaning, chase management, monitor quality, and rate performance, and post HEDIS analytics. Develops and improves workflows and business processes within area(s) to improve customer service, decrease operational costs, and improve overall quality.</li> <li>Identifies and/or analyzes business problems and devises procedures for solutions to the problems.</li> <li>Effectively leads projects in order to produce desired results.</li> <li>Responsible for corporate communication of project results.</li> <li>Recommends and assists with implementing standard policies and procedures.</li> <li>Assures that corporate compliance is communicated, implemented, and monitored on an ongoing basis.</li> <li>Participates in systems testing, develops procedures/controls, and provides recommendations for the ongoing improvement of the updated process.</li> <li>Assists personnel (both internal and external) by answering questions, supplying information, and training.</li> <li>Develops and maintains an effective working relationship with customers.</li> <li>Participates in group or committee discussions.</li> <li>Develops documentation, reports, and presentations for all levels within the organization including executive leadership.</li> <li>Collaborates with Subject Matter Experts to develop accurate documents.</li> <li>Completes ad hoc data requests as assigned. Responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions.</li> <li>Coordinates projects and analysis for management and team.</li> <li>Ensures complete, accurate, and timely data for reporting purposes.</li> <li>Researches, analyzes, identifies, and evaluates data from assigned problems to evaluate existing and potential trends and issues.</li> </ul>
Requirements: <br /> <p><strong>EDUCATION:</strong></p> <ul> <li>Bachelor&rsquo;s degree in a related field.&nbsp;</li> <li>Continuous learning, as defined by the Company&rsquo;s learning philosophy, is required.&nbsp;</li> <li>Certification or progress toward certification is highly preferred and encouraged.</li> </ul> <br /> <p><strong>EXPERIENCE:</strong></p> <ul> <li>Two (2) to four (4) years experience in related field. &nbsp;</li> <li>Analyst experience required with proven experience in operational analysis, data analysis, and problem resolution type activities.</li> </ul> <br /> <p><strong>SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:</strong></p> <ul> <li>Knowledge of HEDIS specifications and processes.</li> <li>Analytical, organizational, planning, and problem-solving skills</li> <li>Understanding and knowledge of the business, products, programs, corporate organizational structure (including functional responsibilities), and basic research principles/methodologies</li> <li>Ability to plan, organize, direct, and control projects.</li> <li>Excellent written and verbal communication skills.</li> <li>Ability to lead and contribute to process improvement projects.</li> <li>Ability to read and interpret documents such as data flows, process flows, technical diagrams, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.</li> <li>Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.</li> <li>Administer and adhere to corporate and departmental policies, practices, and procedures.</li> <li>Knowledge of healthcare information technology and HEDIS medical record review process</li> <li>Strong knowledge and use of Microsoft PowerPoint and Word</li> <li>Advanced Microsoft Excel skills &ndash; pivot tables, complex formulas, macros, etc.</li> <li>Strong analytical, organizational, planning, and problem-solving skills.</li> </ul>